A Night On-Call

July 14, 2011

Hiccups

ID : 22 y/o woman, living with parents. History of migraine headaches.

Unemployed. Accompanied by parents.

3:38am says the red LED display of the alarm clock at my head. I have just wandered out of the concrete shower cubicle attached to my room, and am poised to descend into my bed. I slip my legs under the white sheet and the brown acrylic blanket above it. I lay down and rest my head on the white-cased foam pillow.

“Beep, beeeeeeep. Beep, beeeeeeep.” My pager beckons me. 4:40am notifies my bedside clock. I reach to the phone on my bedside table and punch in numbers displayed on my pager: ER. Not good. I hold the headset to my ear as I lay back down, reclaiming the joys of horizontality, knowing they are soon to be forfeited.

“Dr. Korn speaking”, I mumble into the mouthpiece. “I was paged.”

“I’ll connect you to Dr. Walker,” says the voice on the other end.

I close my eyes, enjoying the brief silence.

“Hi,” the voice rouses me. “You on for Internal Medicine?”

“Yes.”

“Got a consult for you.”

“What is it?”

“Got a girl here with hiccups.”

“Hiccups?”

“Yeah, she says her neurologist told her to come to the ER. She’s been worked up for seizures and found nothing. Neuro won’t see her.”

I am wordless.

“I know it’s a dump, but her parents won’t take her home. So we gotta admit her.”

I hang up the phone, turn onto my belly and scream into the pillow. Fuck you and your hiccups.

I rise out of bed as my legs swing over, feet hitting the cold linoleum. I pull on my scrubs, hitch the pager at my drawstring waist, slip on my shoes and head out. The hall shocks me with its brightness, as I wander to the elevators. I stand in front of the doors and press the “down” button. The black arrow lights up and the numbers above illuminate one by one, right to left. “Ding”. The mouth opens, allowing me into the grey chamber. “Ding”. The lips close. And I descend.

The ER is bright, busy and noisy. Beeps dance around me. “I’m from Internal Medicine. Supposed to see someone with hiccups,” I present myself to a nurse.

“Uh,huh,” she rolls her eyes, pointing to an inch thick file folder on the counter. “Bed Nine.”

I pick up the folder, gather some paper, a clipboard and a pen and head to Bed Nine, toward a plump teenage-like woman with short black hair, sitting up on a gurney, propped by pillows and covered by white sheets. Two figures hover nearby, short friendly-faced grey haired man and woman, like two gnomes sitting at her side. I swallow a sigh as I draw closer. The name stenciled in purple in corner of the file is French.

“Bonjour,” I say, though ‘good day’ feels inappropriate. My command of the language is too limited to provide me with an alternative. “Je m’appelle Dr. Korn.”

“Je m’ appelle -” her head bobs with a tiny cough, “Christina”. The two guardians stand up.

I ask what brought them to the ER and a flow of familiar but indecipherable words, pour from all three, too fast and too altered by Quebecois slang for my comprehension. I shake my head, stare at the lines on the paper in my hand and write at the top: “cc: hiccups”.

“Sorry, do you speak English?”

“Yes, yes . . .” replies the woman. “She –“

“Could Christina tell me the story, first?”

Everyone nods, and her parents sit down again.

Christina tells of her story, punctuated by more bobbing and little coughs. The hiccups start five months ago, on and off for the past five months. She is on medication for a seizure disorder. I flip through the pages of the file. Her neurologist has ordered a CT scan, EEG’s : nothing. This bout of hiccups started three days ago.

“Dr. Wilson said to come here when we called him yesterday,” her mother adds. “We’re waiting to see Dr. Magee next week.”

“Who’s he?”

“A respirologist.”

My watch beeps, announcing 6am. If I write this up by 6:30, I can get another hour of sleep. “Have to get some paperwork done. I’ll be back.”

Sitting at the counter, I put my head down on the white linoleum. A fellow intern sits next to me, his head propped on his arm, while the other hand scrawls stuff on paper a few inches from his chin . The beeps of various tones and speeds of monitors around us become a dizzying symphony. After trying to write with my head still on the table, I sit up, flip through the chart, copy the answers to some of the questions I should have asked and write up the orders. 6:42am. I rise, give the pile to a nurse standing at the counter, graze by Bed Nine. “You’ll be on 6A” and head out.

8 am. I walk into the ward’s computer room, pick up my print-out, and jot a list of “to do”‘s under each name. The list is longer now, filled with admissions from the night before. Rifling through a pink pile of lab results, I pull out sheets with familiar names. Dr. McKim is holding the same two foot-long print-out. “Nine admissions,” I report.

“Okay,” He drinks in a deep breath. “Let’s go.”

At noon, I am wilting and thirsty to go home. Dr. McKim and I sit across from one another at a white linoleum table after our eighteenth bedside meeting. He looks at the wrinkled paper. “Why do I always get the busy nights?” he asks the air.

His self-pity annoys me. You”re sleeping while I am here dealing with all these people! “Just five more to go,” I reassure him.

Our last bed is Christina.

“What brings you here?” asks Dr. McKim.

“Hic (cough)– cups,” she replies.

He looks at me.

“Her neurologist, Dr. Wilson, told to her to go to the ER.” I elaborate. “He just returned my page. He’s coming to see her this afternoon.”

Dr. McKim pauses, as if to wait for me to tell him the truth. “That’s good.” He flips the pages in the binder I have passed him. “He’ll take care of you.,” and wanders out of the room.

I stay behind for a moment, uncomfortable with the swift entrance and exit, though I didn’t know what else to say, or ask. “So, yes, uhmm, Dr. Wilson said he’d come by today.” Christina’s head bobs. Her mother smiles.

“Thanks (cough) for everything.”

What everything?

“Thanks for taking care of m — (cough) -ee last night.”

Care? I had been barely polite. Not even nice, really.

“You are the only per – (cough) – son who didn’t treat me like a – (cough) –